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Why Is My Second Toe Curling?

Posted by: Dr. Marybeth Crane Posted Date: 10/19/2009

A great question was received this weekend from a hiker in Louisiana:  I am not a runner but have been hiking with a backpack for over 19 years with a non painful bunion most of the time unless we travel too many miles in a day. My question is most recently I have begun to have pain in my second toe . It appears to be developing into a hammer toe. Are there non surgical things to do? Also who would be better to see a podiatrist or and orthopedic surgeon? Are there devices I could wear at night that might help? Thank you for your time.

 

Great question! Why is my second toe curling? What can I do about it? Who should I seek advice from?

 

In most circumstances, your second toe is curling because it is trying to stabilize your forefoot in gait. A bunion deformity (a.k.a. Hallux valgus) causes the weight to shift to the second MPJ (or knuckle). Over time, the flexor tendon causes the toe to curl and eventually a hammertoe can occur. This will then become a rigid deformity of the toe and cause pain in the joint.

 

Non-surgical treatment attempts to take the stress off the joint using a Budin splint, hammertoe crest pad, or an orthotic with a metatarsal pad. Once the toe is rigid, surgery is neede to correct the deformity and reduce your pain.

 

The best advice I can give if you are experiencing hammertoe pain is to seek the advice of a board-certified podiatric foot and ankle surgeon. You can find a local one at www.footphysicians.com.

 

Hope this helps! Run Happy! And without toe pain!!

 

Will I Be Able To Run After Bunion Surgery?

Posted by: Dr. Marybeth Crane Posted Date: 08/23/2009

Running After Bunion Surgery?

 

Great question! I hear this question at least several times a month from my active, athletic patients. Of course, my first response is always, “Are you able to run now?” This is not sarcasm, but a true fact finding mission. If you are unable to run before your surgery, due to the pain in your bunions, then if you can run afterwards - I am a hero! The same goes for the opposite. If you are running pain free before surgery, and really only want your bunions fixed due to the fact you think your feet are ugly, if you can’t run afterwards - you really don’t like me very much!

 

Let’s talk about this a little more in depth. A bunion is the result of undue stress on the big toe joint, which causes a protuberance of bone or tissue around that joint.  Bunions can be very painful, inhibit normal walking, and make it difficult to fit into some shoes. Contrary to popular belief, bunions are aggravated, not caused, by tight shoes. They usually are due to inherited faulty foot mechanics which put abnormal pressure on the front of the foot.  Pain is the primary reason patients seek medical attention for bunions. A majority of bunion surgeries are performed on women because they wear tight-fitting, high-heeled shoes that worsen the underlying foot problem and cause abnormal stress to the joint.

 

There’s good news for anyone considering bunion surgery. A survey in 2003 by the American College of Foot and Ankle Surgeons (ACFAS) had surgery performed by a foot and ankle surgeon to correct bunions within the past 6 to 24 months found more than 90 percent of patients who had the procedure say they experienced significant pain relief, increased their physical activity, and would recommend it to others.

Many runners who can benefit from the surgery avoid it and continue to endure pain because they have heard that surgery doesn’t work and is excessively painful. Their biggest fear is that they may not be able to ever run again! The truth, as evidenced by the survey results, is that advanced surgical techniques have allowed us to effectively correct bunion deformities with excellent outcomes in terms of pain relief and improved quality of life.

 

Ninety-six percent of the survey respondents identified pain relief as a desired outcome of the surgery, and 86 percent also said they hoped to improve their walking and increase their physical activity following surgery. On a scale of 1 to 10 with 10 representing “much pain,” the survey respondents averaged a score of 7 when assessing their pain before surgery, and the average score dropped to 2 when they assessed their pain six months after the operation.  Ninety-two percent said they were able to increase their physical activities -- walking, golf, tennis, exercise -- and 90 percent said they would recommend bunion surgery to others. 

 

That being said, in most cases, we can treat the pain caused by bunions conservatively. In fact, we feel strongly that surgery should be a last resort. We surprise many bunion patients with our ability to help them avoid surgery when they have been told previously they have no choice but surgery. A custom foot orthotic to off weight the bunion in your shoes is often very helpful. Many patients run for years pain free in orthotics before they decide to have surgery. If you have tried all conservative treatment, however, and bunion pain is causing pain or limiting your activity, surgery as you can see, can be a very effective option.

 

If the pain in your bunions has caused you to decrease or eliminate running from your life, contact our office for alternatives. Do not let the pain in your bunions change your life!

 

Run Happy!

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